Study raises concern over insulin as addition to metformin for diabetes

摘要

DIABETES patients who use insulin instead of a sulfonylurea — after failing to respond adequately to metformin — are at increased risk of a heart attack, results of a study published in JAMA (2014;311:2288) suggest. The outcome of a non-fatal heart attack or all-cause mortality was cumulatively 30% more likely in metformin-treated patients who received insulin rather than a sulfonylurea (glibenclamide, glipizide, or glimepiride) for tightening glycaemic control. Further analysis indicated that heart attack and stroke rates were similar, but there was a higher incidence of all-cause mortality among patients given insulin.